Clinical diagnosis and treatment experience of 21 case report of isolated sphenoid sinus lesions.

Abstract

Rationale: With the rapid development of medical science and technology, imaging has become an important part of the diagnosis of diseases, which can provide important information about the morphology and scope of the lesion and its relationship with the surrounding tissues. However, due to the fact that isolated pterygoid sinus lesions often have atypical clinical symptoms, and the location of the lesion is deep and the anatomical structure is complex, its diagnosis still faces one of the important challenges, and the misdiagnosis rate is high. The aim of this study was to explore the clinical symptoms, imaging manifestations, and postoperative pathological features of isolated pterygoid sinus lesions, and to summarize the key points of their diagnosis through systematic retrospective analysis, with a view to providing references for clinicians, reducing the misdiagnosis rate of this disease, and improving the level of diagnosis and treatment.

Patient concerns: A retrospective analysis was conducted on the clinical data of 21 patients with isolated sphenoid sinus lesions diagnosed and treated in the ENT department of our hospital from January 2021 to January 2023. Among them, there were 12 cases of headache, 1 case of eye symptoms, 10 cases of nasal symptoms, and 1 case of facial symptoms upon admission.

Diagnoses: Among the 21 cases, there were 10 cases of fungal sphenoid sinus inflammation, 3 cases of sphenoid sinus cyst, 4 cases of chronic sphenoid sinus inflammation, 1 case of sphenoid sinus polyp, 1 case of skull base schwannoma, 1 case of inverted papilloma of sphenoid sinus, and 1 case of cerebrospinal fluid rhinorrhea.

Interventions: In this study, 21 patients underwent endonasal endoscopic pterygoid sinus opening, and all symptoms improved after surgery.

Outcomes: The specific type and clinical manifestations of 21 cases of isolated pterygoid sinus lesions were clarified by imaging and postoperative pathological analysis.

Lessons: Isolated pterygoid sinus lesions vary in type, and clinicians should combine clinical symptoms and imaging manifestations to improve diagnostic accuracy and reduce misdiagnosis. Systematic retrospective analysis helps to summarize diagnostic points and improve reference for clinical practice. Clinical symptoms and imaging examinations help to avoid misdiagnosis of this type of disease.